A comparative study of two treatment methods for choledocholithiasis combined with cholecystolithiasis
10.3760/cma.j.cn113884-20240621-00190
- VernacularTitle:两种胆总管结石合并胆囊结石治疗方案的比较研究
- Author:
Ping ZHANG
1
;
Yubin YUAN
1
;
Shuting JI
1
;
Jie KONG
1
;
Yongqiang YE
1
;
Chen WANG
1
;
Hui LI
1
;
Haiwang ZHAO
1
;
Zhiyong SUN
1
;
Hexian SHI
1
Author Information
1. 菏泽市立医院肝胆外科，菏泽 274000
- Publication Type:Journal Article
- Keywords:
Choledocholithiasis;
Gallbladder stones;
Endoscopic retrograde cholangiopancreatography;
Exploration of common bile duct
- From:
Chinese Journal of Hepatobiliary Surgery
2024;30(12):917-921
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the treatment effect of endoscopic retrograde cholangiopancreatography/endoscopic sphincterotomy plus laparoscopic cholecystectomy (ERCP/EST+ LC) and laparoscopic cholecystectomy plus laparoscopic common bile duct exploration (LC+ LCBDE) for patients with choledocholithiasis combined with gallbladder stones.Methods:Clinical data of 172 patients with choledocholithiasis combined with gallbladder stones treated in Heze Municipal Hospital from March 2018 to March 2021 were retrospectilvely analyzed, including 78 males and 94 females, aged (66.88±9.72) years. According to surgical method, patients were divided into the ERCP/EST+ LC group ( n=86) and LC+ LCBDE group ( n=86). The initial clearance rate of choledochal stones, operation time, intraoperative blood loss and postoperative complications were compared between the groups. Results:The initial clearance rate of the choledochal stones of the ERCP/EST+ LC group is 76.5%(13/17), lower than 96.3%(26/27) of LC+ LCBDE group when the diameter of stones was over 1.2 cm ( χ2=4.07, P=0.044). When the number of choledochal stones were more than 3, the initial clearance rate of the ERCP/EST+ LC group is 78.9%(15/19), lower than that of the LC+ LCBDE group [96.7%(29/30), χ2=3.99, P=0.046]. The operation time of LC+ LCBDE group was longer than that of ERCP/EST+ LC group [(129.07±19.33)min vs. (101.86±27.48)min, t=7.51, P<0.001]. The median intraoperative blood loss of LC+ LCBDE group and ERCP/EST+ LC group was 25.0 (20.0, 30.0) ml and 13.0 (10.0, 15.0) ml, respectively ( Z=916.00, P<0.001). The age, gender, maximum diameter of stones, number of stones, preoperative common bile duct diameter, surgical success rate, postoperative hospital stay, total stone clearance rate, and complication rate were comparable between the groups (all P>0.05). Conclusion:Both LC+ LCBDE and ERCP/EST+ LC are safe and feasible for choledocholithiasis combined with cholecystolithiasis. When the maximum diameter of choledochal stones is ≥1.2 cm or the number of choledochal stones is ≥3, LC+ LCBDE should be favored. When patient is in poor general condition, ERCP/EST+ LC might be more feasible.
